Westgate Practice
Patient Participation Group (PPG)
Minutes of Virtual ZOOM Meeting Monday 8th November 2021
2.00 – 3.45pm
Chair: Pamela Black (Vice Chair)
Present/Joined
- Chair – Pamela Black (previously Usher) (Vice Chair) (PB)
- Prof/Dr Helen Stokes-Lampard (Dr H)
- Sara Allen (SA) – Patient Liaison Officer/Minutes
- Betty Bradbury (BB)
- Judith Plimmer (JP)
- Brian Mills (BM)
- Andy Smith (AS)
- Sue Charles (SC)
- David Dundas (DD)
Apologies
- Shirley Trelfa (ST)
- Pamela Playle-Mitchell (PPM)
- Sheila Espin (SE)
- Sam Ellicott (SEl)
- Margaret Harding (MH)
1. Welcome and Apologies
The meeting was chaired by the Vice Chair Pamela Black (previously Usher) in place of Sheila Espin. There were seven PPG members in attendance together with Prof Helen Stokes Lampard as GP representative and Sara Allen (Patient Liaison Officer) who were welcomed to the sixth virtual Teams meeting; five apologies were noted.
2. Minutes and Actions from previous meeting
Minutes of previous meeting agreed as accurate with one amendment noted for page 7 from BM.
Actions were noted; those items not included in the agenda:
- BM had again raised issue of the long phone message. SA has already discussed with Managers; same for most practices at the moment. SA to raise again, particularly around change of music!
- PB stated that we should ensure that we have a signed off and dated copy of the TOR document as agreed at the previous meeting. All agreed; SA to action.
3. Update of recent practice changes in day to day operating due to covid-19 and covid-19 booster and ‘flu vaccination update (Dr. H)
Dr H reported that there were no substantial changes to day to day operations; still doing face to face appointments as needed, numbers of these have increased over recent months. We are still using ‘Hot Rooms’ for patients with respiratory illness where Covid infection could be a possibility. We have also had some recent issues with ambulance delays due to the pressure on the ambulance service.
SC asked how numbers compare with regards to contact with pre covid. Dr H stated that if you compare all contacts even though we have more staff demand is still up.
PB enquired further re pressure on the ambulance service. Dr H explained that we are waiting for the crews to arrive as they are being delayed at A&E departments; GP surgery is considered a place of safety so we will be a lower priority. The practice is reviewing its current arrangements to deal with medical emergencies.
JP asked if medication reviews are automatically updated Dr H explained that this would not necessarily be the case if a patient has multiple conditions then then they would need all reviews completing and a final medication review to ensure drug compliance and safety.
Dr H went on to explain the role of the Westgate clinical pharmacists in monitoring and reviewing patient medication on an annual basis and also advising about medication use/availability in general.
BG asked if there was a continuing issue with blood tests due to the shortage of bottles Dr H confirmed that there is no longer a shortage of vials so all back to normal.
SA gave an update on covid and flu vaccination numbers (had already been shared with the group by email):
Covid-19 Vaccination Numbers to 3/11/21:
- 1st Doses = 22,424
- 2nd Doses = 21,082
- 3rd Doses have been coded as a booster due to a separate code not being available yet. EMIS are to ‘batch add’ a new code for the immunosuppressed.
- Booster Doses = 3,288 (but have clinics 4th, 5th, 8th Nov adding an additional 1500.
All boosters/3rd vaccines are Pfizer and are being administered at Samuel Johnson. Patients are being invited to book with us 6 months after their last dose or sooner for those requiring a third dose.
Flu Vaccines
We have now held 4 flu clinics at the practice since September for eligible adults with the next one scheduled for Saturday 13th November. Demand has been high again this year.
- Adult Flu = 5,108 (next clinic Sat 13th Nov)
- Child Flu = 310 (ongoing)
4. Latest Practice Workload Statistics/Complaints (SA)
SA gave an update of the latest statistics:
Practice Stats August/September/October 2021 as compared to previous 3 months:
- Telephone Consultations = 10,015 (+ 158)
- Face to Face GP appts = 2,030 (+596)
- Face to Face ANP appts = 863 (+626)
- Face to Face Practice Nurse appts = 3,049 (+313)
- Asthma Reviews = 339 (+37)
- Diabetic Reviews = 305 (+89)
- Medication Reviews = 3,543 (-129)
- Phlebotomists appts = 3082 (+174)
- Smear Tests = 404 (+38)
Complaints:
Total number of complaints received August/September/October = 65
- Via website = 37
- By letter = 19
- Phone call = 2
- Email = 6
- Face to Face = 1
Topics of complaint included:
- Appointment issues (no availability; call time etc)
- Administrative problems (letters/notes/vaccine logging etc)
- Shenstone (branch being closed)
- Arrangements when visiting the practice (requirement to wear mask;
wait outside) - Prescription issues (e.g. unable to order repeats)
- Delays in referrals
- Medication Review (B12 etc)
- Clinical Care/Consultation Issues
11 Letters were sent to patients during this 3 month period with regards to addressing their poor behaviour/attitude.
PB said she was sorry to hear of the abusive behaviour that staff are encountering from the public.
BG requested that compliments be included in the next feedback of these statistics.
DD commented that people are failing to understand the importance of wearing a mask to protect themselves and others.
DD also asked about the ability to send an email to a GP Dr. H explained that this is not part of practice procedure as the emails may go unanswered if the GP is not available. DD also commented about difficulties with prescriptions sometimes being ‘lost’; Dr H responded that we aim not to print online prescriptions but this does sometimes happen if the electronic link doesn’t work properly.
Discussion followed with regards to the ongoing temporary closure of Shenstone Branch Surgery. PB stated that 2 letters had been received one from the Parish Council and one from the local MP along with a petition from those patients who live in Shenstone. Dr H stated that we have tried to do more communications around this issue with notices on the website. A comprehensive response letter has been sent to both the Parish Council and the local MP Mr. Pincher. The partners are reviewing the situation on a monthly basis, may open for planned care but not for care where a possible emergency situation may occur as there is not enough back up available and current ambulance response time is erratic. The partners were disappointed to receive the petition as they are here to serve the community but aim to do it safely.
There was no PPG member from Shenstone present, SEl unable to join the meeting due to technical issues.
DD requested copies of the letters be sent to all PPG members, Dr H agreed for SA to do.
PB stated that the PPG should keep the issue of the Shenstone closure on the agenda and requested that the group be kept up to date with any further developments.
5. Update re Local Council Developments
PB reported that as discussed at the previous meeting a letter had now been sent out to various bodies with regards to the increase in new houses being built in the Lichfield area and subsequent lack of health facilities. To date CCG had not responded; SE has met with local councillor Mr McMahon – report sent to the chair in her absence stating that Mr McMahon understood the concerns about the increasing numbers of houses being built in Lichfield and Staffordshire as a whole. He advised approaching District and County Councillors and in particular Councillor Iain Eadie who has the local plan as part of his portfolio. Appears a strategic approach is needed as it is a county wide issue. Would appear that housing has been high on the agenda but Health facilities have not.
MP Mr Fabricant stated as we had received a response from the city council he would not be doing a separate response, PPG group found this unacceptable as he was there to represent his constituents on a national level, PB will write to him again.
DD stated that the council has no funding; he has already asked for some space on the Cricket Lane site to be allocated for a Health Facility, council are very ahead with housing but not with health. The developers have the upper hand as they do all the input with regards to facilities.
SC thanked PB for doing the letter; asked Dr H about NHS input and commented that Lynn Miller has the remit for local Community Primary Care facilities so may be worth approaching. SA stated that the CCG had given Andy Hadley a new role which included looking into the suitability of local healthcare facilities. DD stated that CCG’s are likely to be merged; Colin Greatorex maybe another contact.
DD also explained how the system works differently in Europe in that councils have more power than the developers. AS commented that the developers do have to agree to put facilities in place but DD responded that they only specify the bare minimum. PB agreed needs to be more action at council level.
Dr. H responded that the partners said thank you for writing the letter; they too are quite shocked at the amount of new house building in the area. They are aware that it will lead to an increase in patient numbers. May be appropriate to use the local Primary Care Network as a platform to raise the issues. However land; money and staffing would be required for any new facility. CCG will become part of the Integrated Care System.
BG asked about the stipulated numbers of patients per GP; Dr H commented that we are still quite well staffed in terms of this ratio so can’t say we are full. SA to get stats for next meeting. PB stated that there did appear to be a capacity issue. Dr H commented that patients are living longer; Lichfield is an affluent area with an older population. PB on SE behalf said that she wanted to raise the issue of capital costs in order to have more knowledge to be able to ask the right questions.
DD stated that money can be used from the private sector to fund health facilities. Dr H explained that 3 models are mainly used in the provision of new Health Care Facilities: in the case of Westgate the practice owns Rotten Row (used for admin & teaching purposes), and Shenstone with money being contributed by NHS. Greenhill Health Centre is owned by NHS property services and rented by us. Partners could buy a property but this is not a popular option; private finance can be used but is a challenging option with pitfalls.
6. Update re CCG & District Feedback (SA for MH)
SA gave feedback in absence of MH:
Notes South East Staffs District Patient Group held 22/9/21
Actions from previous meeting:
106 Monies
CCG’s do claim back when possible, lots of historical issues to tackle; Andy Hadley now taking responsibility for Estates will be 2 new posts to support; looking at general practice in particular.
Community Rapid Intervention Service (CRIS)
Lisa Duncan from the service to attend next meeting to explain how service works.
Thomas Cruxton – update on GP Access
- Some patients happy with remote/telephone appts. Others concerned with accuracy of diagnosis. Where possible GP’s are offering a choice of appt. type.
- Appt rates have gone up – June 2021 up 26% compared with June 2019 shows clear increase in general practice activity. Huge demand in the system; phone lines much busier. CCG has been trying to support practices using demand and capacity modelling. GP appt dashboard provides intelligence and an audit is in progress 110 responses so far from practices to create action plans to improve service provision. Ongoing work with comms team to roll out toolkits with messaging for practices to use on phones, websites etc.
- Patients are afraid that they won’t get the same service from their GP, need to dispel myths and give positive messages.
Section 106/Primary Care Estates update:
- Survey completed to establish factors at GP practices e.g. Condition; access compliance; general suitability
- Andy Hadley heading new team developing & reviewing estate strategies
- CCG aware of significant growth in Lichfield. Discussion are taking place re suitability of current services but takes time and funding.
- Need to consider use of digital technology to free up space; change the way we work and how we work with our patients.
- MH spoke of difficulties at Westgate & Shenstone, no room for expansion.
- Agreement that 106 monies need to be on the agenda
Diabetes update – Fleur Fernando:
- Clinical improvement group set up last year in line with NICE guidance.
- NHSE gave funding for foot care/ screening; examples were given of how the service has improved. Two new workers in Staffs targeting those who would be hard to reach.
- Funding applied for to have 8 band 4 care workers to work in PCN’s to complete the 8 specific diabetic checks, not yet approved but positive feedback.
Pulmonary Rehab Funding – Fleur Fernando:
- Workshops held last year to develop a new integrated model; now at Integrated Partnership level and a business proposal has been put forward.
- Group are looking for people who have breathing difficulties e.g. COPD to be involved
Patient Board Meeting – Derek Hoey
- Lots of time spent reviewing Primary Care Issues
- Nicky Harkness gave feedback on the Integrated Care System; focus now on coming together as a system to improve outcomes and to ensure stay within financial allocations. Concern re level of accountability of Integrated Care Boards. Paper now written re the engagement model to be submitted to Prem Singh this month.
- Nicky Harkness stated that the SE locality is under pressure due to demand for services and numbers of people.
- Covid Rates in Tamworth reported as low compared to rest of the county.
- Future of the George Bryan Centre was discussed in relation to engagement events, who has been involved etc. Overview of the next steps to be taken including equality impact assessment to ensure no one is disadvantaged and travel time analysis to be completed. No action will be taken until approval has been given by Clinical Senate (?)
- Virtual events have been set up for October Thursday 14th 1.30 – 3.00 and Monday 18th 9-11.
- Derek Hoey reported back from the Derby/Burton Trust PPG meeting where a presentation was given by Fran Smith showing how the community hospitals may be used in the future, appear to be very positive ideas. Fran to be invited to next SES District Meeting.
AOB
- AW reported that an NHS link he followed suggested that when Robert Peel or Samuel Johnson are closed then the next urgent care centre is in Washwood Heath! (Maybe as the crow flies) Other centres are Cannock and Stafford.
- AW asked when breast screening unit will return to Robert Peel. CP to speak to the commissioning Team.
PB mentioned that MH had also forwarded a questionnaire on eye care which SA had sent to the group.
7. Correspondence into/out of the Practice
Dr H stated that there is a national issue with consultant letters. They are often not received in a timely way and need to be written more clearly for patient understanding. This has been highlighted by the Ian Patterson case. It is best practice for the letter to be copied to the patient as this often ensures better communications generally.
8. AOB
DD offered to run the meeting using ZOOM rather than TEAMS maybe easier to access. PB thanked him for the offer.
PB wished SE well in her recovery; SA had sent a card from the PPG group. PB suggested meeting towards the end of January 2022; lots of business to discuss. SE would like practical suggestions about how the group can offer support to the practice.
BG said he had colleague who was interested in joining the PPG SA to contact him.
JP requested music on phone is changed; SA has already looked into this but will continue to pursue!
PB wished everyone a Merry Christmas and a hopeful 2022!
9. Date & time of the next meeting
SA/SE to liaise re date/time of next meeting.